Discussion Of The Relationship Between Obesity And Clinical Pathological Characteristics Of Differentiated Thyroid Cancer

Objective:To investigate and discuss the relationship between obesity and clinical pathological characteristics of differentiated thyroid cancer(DTC),clarify the influence and significance of obesity on the clinical pathological features of DTC.Methods:Review the medical records of 330 patients definitely diagnosed as DTC by pathology with the surgery treatment in Xinjiang Military Region General Hospital between January 2007 and October 2017.With body mass index(BMI)Chinese standard to evaluate the degree of obesity,statistical analyse the clinical pathological features of different obese levels DTC patients,and the relationship between obesity and clinical pathological features of DTC.Combined with clinical data,single factor analysis and multifactor Logistic regression analysis were performed to identify the influence and significance of obesity on the clinical pathological features of DTC.Results:(1)In this study,collected 335 TC,PTC 316 cases(94.33%),FTC 14 cases(4.18%),MTC 3 cases(0.90%),ATC 2 cases(0.60%).DTC 330 cases(98.51%),the BMI was 24.39±3.46Kg/m~2,age was 43.65±12.16 years old,maximal tumor diameter was 1.57±1.32cm;121 cases(36.67%)were men,209 cases(63.33%)were women;180 cases(54.55%)less than 45,45 years old and above 150 cases(45.45%);Unifocal TC 234 cases(70.91%),multifocal TC 96 cases(29.09%);Without lymph node metastasis 196cases(59.39%),134 cases(40.61%)with;No distant metastasis 324 cases(98.18%),6 cases(1.82%)with;TNM stage?period 259 cases(78.48%),more than?period 71 cases(21.52%).(2)The 330 DTC patients,including underweight(BMI<18.5)in 10 cases(3.03%),normal(18.5?BMI<24)in 141 cases(42.73%),chubby(24?BMI<28)in 128 cases(38.79%),obese(28?BMI<30)in 31cases(9.39%),severely obese(30?BMI<40)in 20 cases(6.06%).Men compared with women,multifocal tumor compared with isolated tumor,lymph node metastasis compared with the not,more than?period compared with?period,overweight rate increased obviously;The differences were all statistically significant(all P<0.05).And the differences of the overweight rate in different pathological types and different distant metastasis were not statistically significant(all P>0.05).(3)In the 330 DTC patients,normal group(18.5?BMI<24)141 cases,overweight group(BMI?24)179 cases.Significant differences were seen in gender,number of cancer,maximal tumor diameter,lymph node metastasis and TNM stages between the two groups;Overweight group compared with normal group,showed higher incidences of male(P<0.001),multifocal tumor(P=0.048),lymph node metastasis(P=0.004),?period above(P=0.014),and maximal tumor diameter was greater(P=0.044);But no statistical differences in age,distant metastases(all P>0.05).(4)In the 330 DTC patients,chubby group(24?BMI<28)128 cases,obese group(BMI?28)51 cases.Significant differences were seen in the number of cancer,lymph node metastasis between the two groups;Obese group compared with chubby group,showed higher incidences of multifocal tumor(P=0.006),lymph node metastasis(P=0.044);No significant differences were seen in gender,age,maximal tumor diameter,distant metastasis,TNM staging between the two groups(all P>0.05).(5)In the overweight DTC patients,with the increase of obesity degree,the incidences of multifocal tumor,lymph node metastasis increased(all P<0.05).Multiple factors analysis showed that obesity was the risk factor for multifocal tumor occurrence(P=0.001)and lymph node metastasis(P=0.030)of DTC.Conclusion:(1)In this study,Overweight DTC patients compared with normal DTC patients showed higher incidences of male,multifocal tumor,lymph node metastasis,?period above and maximal tumor diameter was bigger.Obesity was significantly correlated with clinic-pathological features such as multifocal tumor,lymph node metastasis of DTC.(2)In the overweight DTC patients,with the increase of obesity degree,the incidences of multifocal tumor and lymph node metastasis increased;Obesity was the risk factor of the multifocal tumor occurrence,lymph node metastasis of DTC.obesity or BMI helps to risk assessment of multifocal tumor occurrence and lymph node metastasis in DTC patients.